How healthy are Australia’s females?

A person’s health status is their overall level of health, and can be measured through self-assessed health status; presence of chronic disease and comorbidities; mental health; sexual heath; life expectancy; and level of disability.

Self-assessed health status

In 2014–15, 58% of females (aged 15+) rated their health as excellent or very good [1].

The proportion of females rating their health as excellent or very good varied with age-group: 67% of women aged 25–34 rated their health as excellent, compared with 36% of women aged 75 years and over.

Chronic disease, comorbidity and burden of disease

Chronic disease

The term chronic disease applies to a group of diseases that tend to be long-lasting and have persistent effects. Chronic diseases have a range of potential impacts on a person's individual circumstances, including quality of life, as well as broader social and economic effects. Chronic diseases also have a significant impact on the health sector.

Self-reported data from the Australian Bureau of Statistics (ABS) 2014–15 National Health Survey (NHS) provides an estimate of the prevalence of chronic disease among the Australian population. Chronic disease data is collected for arthritis, asthma, back problems, cancer, COPD (chronic obstructive pulmonary disease), CVD (cardiovascular disease), diabetes, and mental health conditions. These chronic diseases were selected for reporting because they are common, pose significant health problems, have been the focus of recent AIHW surveillance efforts, and action can be taken to prevent their occurrence. This survey data is self-reported and is therefore likely to under-report the true prevalence of chronic disease. However, using this data enables us to look at the comorbidity of chronic diseases across the Australian population, which is not possible using separate data sources. For more information on data quality see Data sources.

1 in 2

Australian females have a chronic disease

In 2014–15, 52% of females reported having one or more of 8 selected chronic diseases (arthritis, asthma, back problems, cancer, cardiovascular disease, COPD, diabetes and mental and behavioural problems) [1].

Table 1: Selected chronic diseases reported by females, 2014–15

Condition

Number

Per cent

Mental and behavioural problems

2,217,500

19.2

CVD (cardiovascular disease)

2,152,300

18.6

Arthritis

2,110,400

18.3

Back problems

1,872,100

16.2

Asthma

1,369,200

11.8

Diabetes

534,500

4.6

COPD (chronic obstructive pulmonary disease)

297,900

2.6

Cancer

171,400

1.5

Source: ABS 2015 [1]

Note: This survey data is self-reported and likely under-reports the true prevalence of chronic diseases. For more information on data quality see Data sources.

The prevalence of these chronic diseases varies with age:

87% of women aged 65 and over have a chronic disease, compared with 37% of females aged under 45.

Cancer

Cancer describes a diverse group of several hundred diseases in which some of the body’s cells become abnormal and begin to multiply out of control. Some cancers are easily diagnosed and treated, others are harder to diagnose and treat, and most can be fatal. Cancers are named by the type of cell involved or the location in the body where the disease begins.

The primary source of national cancer incidence data is the Australian Cancer Database – a data collection of all primary, malignant cancers diagnosed in Australia since 1982.

17,586 estimated new cases of breast cancer will be diagnosed in 2017, the most common cancer among females.

Mental health

The World Health Organisation defines mental health as ‘a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community.’ Poor mental health may adversely affect any or all of these areas and has consequences for an individual, their family and society.

Nearly 1 in 2

Australian females have experienced a mental health problem

In 2007, more than 3.4 million (43%) females aged 16–85 had experienced a mental disorder in their lifetime [3].

22% of females aged 16–85 experienced symptoms of a mental health disorder in the 12 months.

Chronic disease comorbidities

Some people have more than one chronic disease or health problem at the same time. This is referred to as a comorbidity. Having comorbid chronic conditions can have important implications for a person’s health outcomes, quality of life and treatment choices.

Comorbidity data are presented for the following eight chronic diseases because they are common, pose significant health problems, have been the focus of recent AIHW surveillance efforts, and action can be taken to prevent their occurrence:

arthritis

asthma

back problems

cancer

COPD (chronic obstructive pulmonary disease)

CVD (cardiovascular disease)

diabetes

mental health conditions.

In 2014–15, half of all females (52%) had one or more of these chronic conditions: 27% had one, 15% had two, and 10% had three or more. Chronic disease comorbidity was higher for females than it was for males (25% of all females had two or more chronic conditions, compared with 21% for males). [1]

Burden of disease

Burden of disease quantifies the health impact of disease on a population in a given year—both from dying early and from living with disease and injury. The summary measure ‘disability-adjusted life years’ (or DALY) measures the years of healthy life lost from death and illness.

In 2011, females experienced a smaller share of the total disease burden (46%) than males (54%) [4]. The distribution of overall burden between the sexes varied by disease group. Compared with males, females experienced a greater proportion of the total burden from blood and metabolic disorders (59%), neurological conditions (58%) and musculoskeletal conditions (55%). Nearly half (44%) of the burden of disease in females is from cancer, musculoskeletal conditions, and cardiovascular disease.

Reproductive and maternal conditions were characterised by predominantly female-related conditions, which accounted for the high proportion of burden in females.

After cancer, the ranking of disease groups contributing to total burden of disease differed for females and males. For females, musculoskeletal conditions ranked second, followed by cardiovascular disease, mental & substance use disorders, and musculoskeletal conditions (see Table 2). For males, cardiovascular diseases ranked second, followed by mental & substance use disorders, injuries, and musculoskeletal conditions [4].

Mothers

An important life stage for many women is when they become a mother. The health of a mother and baby can be affected by a mothers' age, where she lives, the socioeconomic conditions in which she lives, the presence of pre-existing or pregnancy related medical conditions, and her risky behaviours such as smoking and drinking alcohol during pregnancy [5, 6]. Data on almost every birth in Australia are collected by midwives and other birth attendants and included in the National Perinatal Data Collection at the AIHW. Among Australian women [7]:

In 2014, 307,844 women gave birth in Australia—an increase of 18% since 2004 (252,871 women)

The rate of women giving birth increased from 59 per 1,000 women of reproductive age (15–44 years) in 2004 to 63 per 1,000 in 2014. The rate has declined from a recent peak of 66 per 1,000 in 2007

The average age of all women who gave birth continues to rise: from 29.7 years in 2004, to 30.2 years in 2014

1 in 9 women (33,280 or 11%) who gave birth in 2014 smoked at some time during their pregnancy, a decrease from 15% in 2009

Almost half of women who gave birth in 2014 were overweight or obese at conception or early in pregnancy (excludes New South Wales)

2 in 3 mothers had vaginal births, 1 in 3 had caesareans in 2014. Caesareans were almost 3 times more common among mothers aged 40 and over

More than half (56%) of pregnant women in 2013 consumed alcohol before they knew they were pregnant and about 1 in 4 (26%) of these women continued to drink, even after they knew they were pregnant.

Life expectancy and mortality

Life expectancy is expressed as either the number of years a newborn baby is expected to live, or the expected years of life remaining for a person at a given age, and is estimated from the death rates in a population.

Australian females born in 2013–2015 can expect to live 34 years longer than females born in 1881–1890 did.

Life expectancy changes over time, and differs between population groups [8, 9]:

females born in Australia in 2013–2015 can expect to live to the age of 84.5 years on average

for Aboriginal and Torres Strait Islander females born in 2010–2012, life expectancy was estimated to be 9.5 years lower than non-Indigenous females (73.7 years compared with 83.1)

Australia is ranked 9th in international comparisons of life expectancy at birth for females at 84.4 years. Japan is ranked 1st with 86.8 years.

Disability free life expectancies

Life expectancies and disability free life expectancies at age 65 are used for monitoring healthy ageing. In 2013–15, life expectancy for women at age 65 (that is, the number of additional years a person aged 65 could expect to live) was just over 22 years [8]. Women aged 65 in 2015 could expect to live an additional 10 years free of disability and around 12 years with some level of disability, including 6 years with severe or profound core activity limitation. This equates to these women living 55% of their remaining life with disability, including 25% with severe or profound core activity limitation [9].

Mortality

Mortality data, such as premature deaths, potentially avoidable deaths and mortality rates can help in understanding death and the fatal burden of disease in the population at a point in time.

Mortality rates vary between population groups. In 2015 [10]:

females accounted for 38% of premature deaths.

females in Very remote areas had a higher percentage of potentially avoidable deaths, with 59% of premature deaths being potentially avoidable, compared with 46% in Major cities.

the median age at death for females decreased with increasing remoteness: from 85 in Major cities to 67 in Very remote areas.

the median age at death for females also decreased with increasing socioeconomic disadvantage: from 86 years in the highest socioeconomic group to 83 in the lowest socioeconomic group.

Causes of death

Monitoring causes of death is helps to measure the health status of a population. Causes of death can be used to assess the success of interventions to improve disease outcomes, signal changes in community health status and disease processes, and highlight inequalities in health status between population groups.

In 2015, there were 77,772 deaths among Australian females. The leading cause of death was coronary heart disease, followed by dementia and Alzheimer disease, and cerebrovascular disease. Females were almost twice as likely to die from dementia and Alzheimer disease as males, accounting for 65% of all deaths from dementia and Alzheimer disease.

Figure 6: Leading causes of death among females, 2015

Notes:

Data are based on year of registration of death; deaths registered in 2015 are based on the preliminary version of cause of death data and are subject to further revision by the ABS.

Leading causes of death are based on underlying causes of death and classified using an AIHW-modified version of Becker et al. 2006. International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes are presented in parentheses.

Source: AIHW 2017 [10] (Table S6).

Breast cancer mostly affects females and is the 6th leading cause of death for females. Between 1984–1988 and 2009–2013, 5-year relative survival from breast cancer improved from 72% to 90% [11].